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Confidentiality

Every time I visit the doctor, when I check in at the front desk I am asked to confirm that I haven’t changed my mailing address or insurance since my last visit. Then I scrawl my signature beside the X so that the office can bill my insurance for me (which I appreciate, since I’m old enough to remember paying cash at the doctor’s office and then submitting the bill to my insurance for reimbursement).

There are a bunch of teeny-tiny letters near the signature X. Did you ever take a magnifying glass to read that fine print? It authorizes your doctor to disclose whatever information the insurance company wants.

Just when I had read enough medblogs lauding patient privacy that I almost believed that I could tell my doctor anything and have it remain confidential, we were in a wreck. When I saw my doctor about our MVA, he included a copy of his chart notes along with his bill to the auto insurance company. If he only submits a bill, the insurance company asks for more details. That makes extra work for his staff. He gets paid quicker if he just sends everything at once. I’m a big fan of efficiency.*

Since the auto insurer (just like the medical insurer) required me to sign a waiver, it’s perfectly legal for the doctor to send information to them. I don’t object to my doctor doing what he needs to do to get paid. I object to the waiver. This waiver goes way overboard. The auto insurer doesn’t only want access to visits pertaining to the accident; they want access to all my medical records. In fact, I had to sign that waiver TWICE! Once for the adjuster who handles medical bills, and once for the adjuster who handles injury claims. I don’t even want a monetary settlement, but they keep saying that I’m entitled to one. And now the other driver’s insurer wants me to sign a waiver so that they can look at my medical records, too. Look, just pay the bills related to the accident and I’ll be happy. I’ve tried to keep costs down. Leave my medical records alone.

Not only do I have two different auto insurers asking for my medical records, my medical insurer is taking a closer look. Even though the hospital billed the auto insurer for my $14K visit to ER, they forgot to give that information to the x-ray people so the x-ray people billed my medical insurance. Oops. My medical insurer sent me a letter saying, “It looks like you were in an accident.”

If you ever get one of those letters after a wreck, DO NOT RESPOND.**

Just call whoever issued the bill and give them the right billing info, or forward the bill to the auto insurer. Trying to be straightforward and helpful, I did the wrong thing. Never again. Now my medical insurer thinks that every claim with my name on it is due to the wreck. They have denied the lab’s claim for my routine bloodwork. When I called to try to straighten that out, they said that a generic billing code was used – something about “unexplained pain” – and they will need supporting information.

SIGH

So, because I was in a car wreck through no fault of my own (I was a passenger!), now my rheumatologist and podiatrist have to release additional information to my insurance company. Neither doctor has been paid for my August appointments. Or my September appointments. And the lab isn’t getting paid. I hate for people to not get paid in a timely manner. And I have three more appointments in the upcoming week.

There’s no such thing as patient-doctor confidentiality. Insurance companies have been invading people’s privacy for years.

Think it couldn’t get any worse? Now the government wants in. Big Brother is here.

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*I’ve seen my doctor’s chart notes. They’re amazingly generic. He must keep separate pages with his thoughts, things to keep an eye on in the future, etc., somewhere else. I’ve seen him flip pages to find the information that jogs his memory; he can pull up stuff from years ago when there’s nothing about it in the chart notes. Part of me is really curious what kinds of things he’s writing “for his eyes only” and part of me is kinda glad he has this system. That might be a tiny bit of privacy if his staff selects pages to be mailed. If an auditor sits down with the entire chart, there’s no privacy at all.

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3 thoughts on “Confidentiality”

Unfortunately this is the method now used to find insurance fraud. With all the talking heads grandstanding against medical fraud and waste as a way to save American Medicine I’m afraid the result may be hassling doctors and patients with more mountains of paperwork and bureaucratic road blocks.

I’m against fraud as much as the next guy, but the main way insurance seems to police the system is to assume everyone is guilty until proven otherwise.